Dyspareunia
Dyspareunia[edit | edit source]
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Definition[edit | edit source]
Dyspareunia is defined as persistent genital pain that occurs during sexual intercourse.[1]
Clinically Relevant Anatomy[edit | edit source]
Clinical Presentation[edit | edit source]
Subjective History
Symptoms
Individuals may present with pain that occurs at entry during penetration, with deep penetration or lasting post-penetration. Pain associated with the insertion of a tampon could also be another subjective report. Words used to describe pain may be (but are not limited to): "throbbing" "burning" or "aching."
Casuses
Pain that occurs at entry during penetration can be due to:
- vestibulodynia
Pain during deep penetration can be due to:
- endometriosis
-
Objective Assessment
A pelvic assessment, including an internal exam, performed by a trained medical professional with the informed consent of the patient.
Management / Interventions[edit | edit source]
Medical management
Ensure that the patient has been screened by a physician to rule out any differential diagnoses.
Physiotherapy
If hypertension of the pelvic floor muscles is an issue, then teaching the patient how to relax these muscles can increase comfort during initial and deep penetration.
Additional Considerations:
- If this has become a chronic issue, addressing principles of centralized pain and explaining this to the patient can be helpful and informative.
- The use of a multidisciplinary approach with the inclusion of a physician and a counselling therapist could also beneficial.
Differential Diagnosis[edit | edit source]
- skin irritation (ie. eczema or other skin problems in the genital region)[1]
- interstitial cystitis[2]
- fibromyalgia[2]
- irritable bowel syndrome[2]
